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1 st Quarter 2016 Outlook January–March Prepared For: AHRA January 2016 1

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Page 1: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

1st Quarter 2016 Outlook January–March

Prepared For: AHRA January 2016

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Page 2: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

Why was MICI created? The MarkeTech Group and AHRA collaborated on the

creation of MICI based on the belief that measuring the confidence of US medical imaging administrators on a regular basis would provide a valuable index for those having an interest in this industry. The MICI panel consists of a select group of imagePRO™ panel members from around the U.S. representing different hospital sizes and geographic locations to capture a true “industry outlook”: how imaging administrators see the future of medical imaging in regard to revenues, costs, purchasing, and growth. This exciting initiative captures the “mood” of imaging administrators on a quarterly basis regarding the state of medical imaging in the U.S. It also provides a unique statistical index that is likely to attract a lot of attention from those following this industry.

2

MICI Overview

What is imagePRO™ and why is it important?

imagePRO™ was created by The MarkeTech Group to provide a professional community for imaging administrators to participate in studies aimed at advancing the development of medical imaging technology.

The imagePRO™ panel is a true community of industry professionals and is the leading opt-in panel of this industry. Members are subjected to strict enrollment requirements to represent the voice of their peers and to be part of a group of professionals whose knowledge and input is important.

Page 3: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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Index Methodology

169 imaging directors/managers

of hospitals completed the 3-minute Web survey regarding their perception of medical imaging trends for the first quarter of 2016.

Scores measure the level of confidence, and range between 0 to 200. The score interpretation follows:

o Below 50 is extremely low confidence o 50 to 69 is very low confidence o 70 to 89 is low confidence o 90 to 110 reflect an ambivalent score (Neutral) o 111 to 130 is high confidence o 131 to 150 is very high confidence o Anything above 150 is extremely high confidence

Hospital bed size:

44% Under 100

36% 100-299

20% 300 or more

Page 4: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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Index Methodology

Recruitment accounts for about 90% of correct hospitals and regions to reflect the U.S. hospital market.

o While relatively minor in magnitude, the weighting accounts for the final 10% to refine the estimates and ensure they represent the U.S. hospital market.

o This refinement is necessary to create an index that truly represents how radiology departments view the economic outlook for the current quarter and will ensure that subsequent MICI results are valid.

Results are reflective of national trends because of the manner in which participants were invited to participate.

o Participants were recruited by region and number of beds to reflect known AHA incidence.

o Once the final counts were confirmed there was some

statistical adjustment—weighting—to ensure the index reflects the U.S. hospital imaging market. This type of adjustment is common when estimating overall market share, trends, and attitudes.

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Page 5: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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Index Methodology

Regions

Pacific 9%

Mountain 7%

West South Central 12%

Mid-Atlantic 15%

South Atlantic 15%

West North Central 14%

East North Central 21%

East South Central 7%

Page 6: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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There is very high confidence that staff costs will remain constant. High confidence in growing diagnostic and interventional radiology and as a profit center.

Topic Score Mean

Interpretation

Will grow monthly in diagnostic and interventional radiology

114 High confidence

Receive adequate reimbursement from Medicare for diagnostic and interventional imaging

71 Low confidence

Internal operating and staff costs will remain constant

132 Very high

confidence

Will have access to capital for imaging equipment and IT needs

102 Neutral

Will maintain/grow as a profit center 124 High confidence

Composite score across all areas 108 Neutral

There is concern about receiving adequate reimbursement from Medicare.

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Page 7: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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Hospital bed size differences:

Hospitals with 100 or more beds are more confident that growth in diagnostic and interventional radiology will occur than hospitals with fewer than 100 beds. Hospitals with less than 100 beds are more confident that staff costs will remain constant.

Topic

Score Mean

Under 100 beds

100 to 299 beds

300 or more beds

Will grow monthly in diagnostic and interventional radiology

102 122 125

Receive adequate reimbursement from Medicare for diagnostic and interventional imaging

70 70 73

Internal operating and staff costs will remain constant

143 127 119

Will have access to capital for imaging equipment and IT needs

98 104 104

Will maintain/grow as a profit center 118 128 128

Composite score across all areas 106 110 109

Page 8: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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Regional differences: While none of the differences are statistically significant:

Mid-Atlantic, East North Central, West North Central, East South Central, Mountain, and Pacific regions have very high confidence that internal operating and staff costs will remain constant.

Mountain region has very high confidence in growing as a profit center.

Topic

Score Mean

Mid-Atlantic

South Atlantic

East North

Central

West North

Central

East South

Central

West South

Central Mountain Pacific

Will grow monthly in diagnostic and interventional radiology

114 115 112 112 106 119 124 112

Receive adequate reimbursement from Medicare for diagnostic and interventional imaging

63 69 79 80 57 74 82 51

Internal operating and staff costs will remain constant

133 122 133 135 139 130 131 142

Will have access to capital for imaging equipment and IT needs

103 98 106 107 85 101 98 102

Will maintain/grow as a profit center

129 124 124 114 106 127 142 123

Composite score across all areas 108 105 110 110 97 110 114 106

The Mid-Atlantic, South Atlantic, East South Central, and Pacific regions have very low confidence; while all other regions have low confidence about receiving adequate reimbursement from Medicare. East South Central region has low confidence in access to capital for equipment.

Page 9: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

While the Mid-Atlantic, South Atlantic, East South Central, and Pacific regions region have very low confidence; all other regions have low confidence about receiving adequate reimbursement from Medicare. The East South Central region has low confidence in access to capital for equipment.

Mid-Atlantic, East North Central, West North Central, East South Central, Mountain, and Pacific regions have very high confidence that internal operating and staff costs will remain constant. Mountain region has very high confidence in growing as a profit center.

Hospitals with 100 or more beds are more confident in growth of diagnostic and interventional radiology than hospitals under 100 beds. Hospitals with fewer than 100 beds are more confident in staff costs will remain constant.

There is concern about receiving adequate reimbursement from Medicare.

There is very high confidence that staff costs will remain constant; while there is high confidence in diagnostic and interventional radiology and growing as a profit center.

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Summary

1

2

3

4

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Page 10: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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One year analysis review Q2-2014 through Q1-2016

Results are now shown for Q2 2014 through

Q1 2016.

o Comparisons are presented to show any trending of the data over a one year period.

Analyses are based on between

group analysis of variance (ANOVA) where participant’s scores are compared over time to determine if changes occur.

Page 11: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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One year analysis review Q4-2015 through Q1-2016

Topic

Score Mean

Q4 2015 Q1 2016

Will grow monthly in diagnostic and interventional radiology

118 114

Receive adequate reimbursement from Medicare for diagnostic and interventional imaging

77 71

Internal operating and staff costs will remain constant 133 132

Will have access to capital for imaging equipment and IT needs

101 102

Will maintain/grow as a profit center 125 124

Composite score across all areas 110 108

No statistically significant differences in confidence for any of the MICI scores between Q4 2015 and Q1 2016.

Page 12: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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One year analysis review Q2-2014 through Q1-2016

50

75

100

125

150

2nd quarter 3rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter 4th quarter 1st quarter

2014 2015 2016

Ave

rag

e M

ICI

Sco

res

Quarter

Will grow monthly in diagnostic and interventional radiology

Receive adequate reimbursement from Medicare for diagnostic and interventional imaging

Internal operating and staff costs will remain constant

Will have access to capital for imaging equipment and IT needs

Will maintain/grow as a profit center

Composite score across all areas

TRENDING: Access to capital for equipment have higher confidence in Q1 2016 compared to Q4 2014. No significant differences in all areas from Q1 2015 to Q1 2016.

Margin of error: ±8 percentage points

Page 13: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

50

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125

150

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Grow monthly Receive adequate

reimbursement

Costs remain constant Access to capital Maintain/grow as a

profit center

Ave

rag

e M

ICI

Sco

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One year analysis review Q2-2015 through Q1-2016

Click here to see more information

Under 100 beds

100 to 299 beds

300 or more beds

Margin of error: ±8 percentage points

For details on MICI scores by bed size – please click on underlined links, or go to Appendix B.

Click here to see more information

Click here to see more information

Click here to see more information

Click here to see more information

Page 14: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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One year analysis review Q2-2014 through Q1-2016

1 2

3

In aggregate, the MICI scores between Q1 2016 and Q4 2015 have not changed and are not statistically significant.

Under 100 beds: Access to capital for equipment, internal operating and staff costs will remain constant have higher confidence in Q1 2016 compared to Q2 2014.

100 to 299 beds: Growth of diagnostic and interventional radiology and access to capital for equipment have higher confidence in Q1 2016 compared to Q2 2014.

Summary

300 or more beds: No changes in MICI between Q1 2016 and Q2 2014.

4

Page 15: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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Study & report have been conducted & brought to you courtesy of:

Page 16: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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Appendix: January to March 2016 results

Grow monthly in diagnostic and interventional imaging Over the next three months, I am very optimistic that our department:

S1Q1. will grow monthly study volumes in Diagnostic imaging modalities (X-ray, Ultrasound, MRI, CT and NM).

S1Q2. will grow monthly study volumes in Interventional imaging modalities (biopsy, angio cath lab, etc.).

APPENDIX A - Questionnaire

Receive adequate reimbursement from Medicare for diagnostic and interventional imaging Over the next three months, I am very optimistic that our department:

S1Q3. will receive adequate reimbursement from Medicare for Diagnostic imaging studies.

S1Q4. will receive adequate reimbursement from Medicare for Interventional imaging procedures.

Internal operating and staff costs will remain constant Over the next three months, I am very optimistic that the imaging department:

S2Q1. internal operating expenses (not including staff costs) will remain constant.

S2Q2. internal staff costs will remain constant.

Page 17: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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Appendix: January to March 2016 results

Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic that our department:

S3Q1. will have access to capital/credit to fund investments in new imaging equipment and the costs associated with Imaging capital projects (e.g. siting & construction costs).

S3Q2. will have access to capital/credit to fund investments in areas outside of imaging equipment, such as PACS, RIS, or other imaging-related IT needs.

S3Q3. will have access to capital/credit to fund investment in imaging facility expansion, if desired.

APPENDIX A - Questionnaire

Will grow as a profit center Over the next three months, I am very optimistic that our department:

S4Q1. will continue to maintain/grow Diagnostic imaging services as a profit center.

S4Q2. will continue to maintain/grow Interventional imaging services as a profit center.

Page 18: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

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Appendix: Q2-2014 through Q1-2016 results

Graphs are presented by number of beds to show MICI for all quarters.

APPENDIX B

Interpretation is by number of beds—any changes across quarters are identified as being significant.

If no changes are identified then differences that might appear are due to random fluctuation in responses over time and should not be considered real.

Page 19: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

50

75

100

125

150

175

2nd quarter 3rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter 4th quarter 1st quarter

2014 2015 2016

Ave

rag

e M

ICI

Sco

res

Quarter

Hospital bed size: Under 100 beds

Will grow monthly in diagnostic and interventional radiology

Receive adequate reimbursement from Medicare for diagnostic and interventional imaging

Internal operating and staff costs will remain constant

Will have access to capital for imaging equipment and IT needs

Will maintain/grow as a profit center

Composite score across all areas

19

Appendix: Q2-2014 through Q1-2016 results

Under 100 beds: No changes in MICI between Q1 2016 and Q4 2015. Access to capital for equipment, internal operating and staff costs will remain constant have higher confidence in Q1 2016 compared to Q2 2014.

Back to Hospital bed size summary

Page 20: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

50

75

100

125

150

175

2nd quarter 3rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter 4th quarter 1st quarter

2014 2015 2016

Ave

rag

e M

ICI

Sco

res

Quarter

Hospital bed size: 100 to 299 beds

Will grow monthly in diagnostic and interventional radiology

Receive adequate reimbursement from Medicare for diagnostic and interventional imaging

Internal operating and staff costs will remain constant

Will have access to capital for imaging equipment and IT needs

Will maintain/grow as a profit center

Composite score across all areas

20

Appendix: Q2-2014 through Q1-2016 results

100 to 299 beds: No changes in MICI between Q1 2016 and Q4 2015. Growth of diagnostic and interventional radiology and access to capital for equipment have higher confidence in Q1 2016 compared to Q2 2014.

Back to Hospital bed size summary

Page 21: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

50

75

100

125

150

175

2nd quarter 3rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter 4th quarter 1st quarter

2014 2015 2016

Ave

rag

e M

ICI

Sco

res

Quarter

Hospital bed size: 300 or more beds

Will grow monthly in diagnostic and interventional radiology

Receive adequate reimbursement from Medicare for diagnostic and interventional imaging

Internal operating and staff costs will remain constant

Will have access to capital for imaging equipment and IT needs

Will maintain/grow as a profit center

Composite score across all areas

21

Appendix: Q2-2014 through Q1-2016 results

300 or more beds: No changes in MICI between Q1 2016 and Q4 2015.

Back to Hospital bed size summary

Page 22: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

50

75

100

125

150

175

2nd quarter 3rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter 4th quarter 1st quarter

2014 2015 2016

Ave

rag

e M

ICI

Sco

res

Will grow monthly in diagnostic and interventional radiology: Hospital bed size

Quarter

Under 100 beds 100 to 299 beds 300 or more beds

Appendix: Q2-2014 through Q1-2016 results

Back to Hospital bed size summary

22

Page 23: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

Appendix: Q2-2014 through Q1-2016 results

Back to Hospital bed size summary

23

50

75

100

125

150

175

2nd quarter 3rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter 4th quarter 1st quarter

2014 2015 2016

Ave

rag

e M

ICI

Sco

res

Receive adequate reimbursement from Medicare for diagnostic and interventional imaging: Hospital bed size

Quarter

Under 100 beds 100 to 299 beds 300 or more beds

Page 24: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

50

75

100

125

150

175

2nd quarter 3rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter 4th quarter 1st quarter

2014 2015 2016

Ave

rag

e M

ICI

Sco

res

Internal operating and staff costs will remain constant: Hospital bed size

Quarter

Under 100 beds 100 to 299 beds 300 or more beds

Appendix: Q2-2014 through Q1-2016 results

Back to Hospital bed size summary

24

Page 25: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

50

75

100

125

150

175

2nd quarter 3rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter 4th quarter 1st quarter

2014 2015 2016

Ave

rag

e M

ICI

Sco

res

Will have access to capital for imaging equipment and IT needs: Hospital bed size

Quarter

Under 100 beds 100 to 299 beds 300 or more beds

Appendix: Q2-2014 through Q1-2016 results

Back to Hospital bed size summary

25

Page 26: 1st Quarter 2016 Outlook January March · January to March 2016 results Will have access to capital for imaging equipment and IT needs Over the next three months, I am very optimistic

50

75

100

125

150

175

2nd quarter 3rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter 4th quarter 1st quarter

2014 2015 2016

Ave

rag

e M

ICI

Sco

res

Will maintain/grow as a profit center: Hospital bed size

Quarter

Under 100 beds 100 to 299 beds 300 or more beds

Appendix: Q2-2014 through Q1-2016 results

Back to Hospital bed size summary

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